Electronic consults for improving specialty care access for veterans

David E. Winchester, Anita Wokhlu, Juan Vilaro, Anthony A. Bavry, Ki Park, Calvin Choi, Mark Panna, Michael Kaufmann, Matthew McKillop, Carsten Schmalfuss

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


OBJECTIVES: We adopted e-consults within an active referral management (ARM) process for our Veterans Health Administration (VHA) outpatient cardiology clinic to reduce clinic wait times. STUDY DESIGN: Prospective multiphase cohort study. METHODS: Our ARM process consisted of reviewing all incoming consult requests for our outpatient clinic and triaging the requests to either an e-consult or a clinic visit. The primary outcome was wait time for an appointment in our clinic. RESULTS: Median wait time prior to the ARM process was 24 days. After implementation of the ARM process, wait times decreased to 13 days (46% reduction). Approximately 60% of incoming consults could be triaged into e-consults, predominantly by managing stable diseases or minor symptoms. CONCLUSIONS: E-consults and ARM of clinical referrals were effective at reducing wait times for our outpatient VHA cardiology clinic. The majority of clinical referrals could be handled through an e-consult and did not require an in-person clinic visit.

Original languageEnglish (US)
Pages (from-to)250-253
Number of pages4
JournalAmerican Journal of Managed Care
Issue number5
StatePublished - 2019
Externally publishedYes

ASJC Scopus subject areas

  • Health Policy


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